PRINCIPLES OF INJURY PREVENTION & MANAGEMENT INFORMATION SHEET FOR PLAYERS

Over half of injuries will be during a match whilst

OVERVIEW

over 1/3 are sustained during training

Some players are designed for sports; they have the

Lower limb injuries remain the most prevalent

talent, the mechanics and luck not to get injured. Others

(Football - 76.3%, Hurling – 69%)

get injured regularly, or simply do not have the required

50-60% of injuries occur in the second half of play

mechanics that allow their bodies to withstand the forces applied in playing Gaelic Football or Hurling (Murphy & Blake, 2012). The challenge is to ensure that all players are prepared to the best of their abilities and that they engage in our games where the risks have been considered and controlled as far as possible. There are basically two types of injuries: acute injuries and overuse injuries.

Acute injuries are usually the

result of a single, traumatic event. Examples include wrist fractures, ankle sprains, shoulder dislocations, and hamstring strains. Although there is no clear consensus on the definition of overuse injury, it is generally recognised that overuse injuries are subtle and usually occur over time. They are the result of repetitive microtraumas to the tendons, bones and joints.

Overuse

injuries can affect muscles, ligaments, tendons, bones, and growth plates.

Common examples include tennis

elbow, swimmer’s shoulder, runner’s knee, Achilles tendinitis and shin splints.

RISK FACTORS EXTRINSIC

INTRINSIC

Exposure

Physical characteristics



Type of sport



Exposure time



Position in the team



of

Level competition Training

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

Body composition (e.g. body weight)



Health (e.g. previous injuries)



Physical fitness Anatomy abnormalities



Amount



Motor abilities and sports-specific skills



Frequency

Psychological profile

 Intensity Environment 

Type of surface



Indoor v Outdoor



Weather conditions



Time of season



Human factors (coaching, referees, rules, team mates, opponents)

playing

Equipment 

injury per season old injury

Gender



Over 1/3 of players will have more than one Up to 1/4 of injuries will be a recurrence of an



Type

we know that: at least once in a season

Age



From monitoring injury in Gaelic games as past 7 years, 2 out of every 3 players on a team will get injured





Protective equipment helmet, mouthguards)

(e.g.

Playing equipment (e.g. footwear, clothing)



Motivation



Risk taking



Stress coping

WARM-UP, COOL-DOWN, STRETCH

matches only the running exercises (Parts A & C) should or may be performed.

WARM-UP The purpose of the warm-up is to prepare you for the training to follow.

During the warm-up, body

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temperature is raised, which is one of the main factors in facilitating

performance.

The elevation

of

COOL-DOWN

body

temperature warms up and stretches muscles, tendons,

A cool-down brings the body back to its normal

ligaments, and other tissues, which prevents or reduces

functions. During a cool-down of 20 minutes, athletes

ligament sprains and tendon and muscle strains.

perform activities that facilitate faster regeneration and recovery from strains of training.

Players should not

GAA 15

leave for showers immediately after the last exercise. As

In 2011, the Medical, Scientific and Welfare Committee

a result of training, especially intensive training, athletes

of the GAA in conjunction with a working group

build up high amounts of lactic acid and their muscles are

comprising of Dr. Pat O’Neill, Prof. Niall Moyna, Dr. Pat

exhausted, tense, and rigid. To overcome this fatigue and

Duggan, Dr. Kieran Moran, John C. Murphy, Dr.

speed up the recovery process, they should perform

Catherine Blake developed the GAA 15, a standardised

stretching exercises.

injury prevention programme aimed at reducing the

necessary if the effect of fatigue is to be eliminated.

The removal of lactic acid is

number of injuries sustained by GAA players. The GAA 15 is based on programmes incorporated internationally

STRETCHING

by FIFA (the 11+) (FMARC) and by the Santa Monica

Stretching is a simple and effective activity that helps to

Orthopaedic and Sports Medicine Research Foundation

enhance athletic performance, decrease the likelihood of

(PEP) in soccer. The effectiveness of the FIFA 11+ was

sports injury and minimise muscle soreness. As a result

proven in a scientific study which found that teams that

of this, a reduction in general muscle tension is achieved

performed the 11+ at least twice a week had 30-50% less

and range of movement is increased. By increasing range

injured players.

of movement we are increasing the distance our limbs can move before damage occurs to the muscles and

As a result of the findings from injury surveillance in

other soft tissues. The benefits of an extended range of

Gaelic games over a six year period and expert opinion,

movement includes increased comfort, a greater ability to

the GAA 15 was devised with the defining feature being

move freely, and a lessening of the susceptibility to soft

the gluteal activation which is considered important for

tissue injuries like muscle and tendon strains and ligament

preventing injury in GAA players. An 8 week pilot of the

sprains.

programme in UCD by Edwenia O’Malley found clinically important improvements in dynamic balance and jump

PHYSICAL CONDITIONING

landing technique in GAA players. Appropriate physical conditioning decreases the risk of The GAA 15 should be performed, as a standard warm-

injury, the severity of an injury should it occur, and help

up, at the start of each training session at least twice a

prevent re-injury. Optimal physical conditioning requires

week and takes 15 minutes to complete.

adequate

2

Prior to

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muscular

strength

and

balance,

power,

endurance,

neuromuscular

control,

joint

flexibility,

cardiovascular endurance and good body composition.

experience is a normal part of training, allowing adequate time for recovery enables the body to prepare for the next bout of training. This cycle of training and recovery

TYPE

DESCRIPTION

EXERCISES

called periodization of training allows players to keep

Strength

Players can apply force against resistance

Body weight strength training Resistance training using stretch bands, free weights or machines

improving over time.

Enables players to move the body or parts of the body rapidly

Short bursts of speed integrated into normal training session

adequate rest, is not normal.

Players can combine speed and strength to produce explosive force

Hill sprints Squat jumps

Provides a greater range of pain-free motion

Stretches in warm-up, cooldown and stretch

recovered properly from the previous training session or

Allows players to repeat the same action or exercise continuously without getting too tired.

Circuit training Long runs or jogs

successive workout, the risk of injury increases. A point

Reduces the risk of tripping, falling or landing in an awkward position. It also reduces the risk of a player overbalancing on uneven surfaces.

Balancing on one leg with eyes closed

Speed

Power

Flexibility

Endurance

Balance

Eliminating or reducing these recovery sessions leads to players failing to recover from hard training. Prolonged fatigue lasting two weeks or more, despite It is important to use

recovery strategies after training to benefit maximally from all the hard training you are doing. Infections and injuries are generally inescapable if players repeatedly train or play before their bodies have game. As fitness levels continue to decrease with each is eventually reached where injury becomes inevitable, forcing players to stop training. Recovery involves: Replacing fluids and energy Reducing muscle damage Reducing psychological symptoms of fatigue, such as anxiousness and irritability

HYDRATION Adequate recovery begins long before the players leave

REST AND RECOVERY When recovery from training and games is improved, players are able to train sooner with better quality than when either no or inappropriate practices are completed. The ultimate goal of recovery for players is to restore their bodies and minds back to pre-activity levels in the shortest possible time. During hard training, the majority of athletes will become fatigued and performances will actually drop. Whilst this 3

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the playing area or gym — it starts during the session. By trying to maintain proper hydration during training or games, players can reduce the amount of dehydration they will experience. Dehydration is the loss of fluids and other electrolytes from the body and it occurs through sweating and exhaling. The only way to prevent dehydration is proper hydration. Replacing the energy used during exercise and the fluids and electrolytes lost through sweating is important within the first 2 hours after completing training or a game.

Soup

with

pasta/noodles/rice

and

Knowing how much fluid is lost will provide a good

meat/chicken/legume

indication of the level of fluid intake required by each

Don’t forget to have a large drink with this meal,

player. There are a number of different ways of assessing

and sip fluids regularly during the hours after

a player’s hydration status; however a simple method is

training and games. Fruit should always be

to weigh a player before and after training and games.

available to players to snack on.

The weight difference is the amount of fluid lost from the body through sweating. Ensure that the player is wearing

Complete recovery is not achieved in just a few hours

as little clothing as possible each time you weigh him.

after the game; it can often take more than 24 hours.

Remember for each 1Kg of weight lost, 1.5 litres of fluids

Adequate fluid and food intake is important over the next

must be consumed. Water is fine for most people after

couple of days to ensure optimal recovery and

exercise, as long as it is accompanied by a meal or snacks

preparation for the next game ahead!

to provide for carbohydrate and electrolytes used during

TIPS

exercise. However, if a player does not feel like eating solid foods in the hours after exercise, it is important to

Sipping 125 — 250ml of water or a sports drink

drink fluids containing other nutrients such as a sports

every 15 — 20 minutes can keep fluid levels

drink, milk drink or smoothies.

topped up during activity. During the cool down and stretching, water,

NUTRITION

sports drinks and fruit should be available to

Protein and carbohydrate are essential nutrients for

players to begin this process.

recovery. The meal or snacks consumed after training or

Drinking 500ml of a sports drink immediately

games should contain a source of each. A snack such as a

after training or a game will help replace lost

chicken and salad roll (white bread) is a good option.

fluids and also replenish used energy stores. A sports drink containing a source of vitamin C,

Fruit, dried fruit/almonds and museli bars are other

vitamin E or protein is useful to repair muscle

alternative snacks after training or a game. The meal

damage.

eaten in the hours after exercise can make a big

If the sports drink does not contain protein

difference to recovery, and should contain a source of

eating a small snack, such as a chicken or turkey

protein (such as chicken, turkey, tuna or lean beef) and

sandwich at this time will also be useful.

carbohydrate (such as potatoes, pasta, rice or noodles),

Energy drinks such as Red Bull and Monster X

but not too much fat.

will not help to keep players hydrated as they contain large amounts of caffeine which is a

Good examples include: Beef and vegetable stir-fry with rice or noodles

diuretic

therefore

contributes

to

further

dehydration.

Pasta with chicken or lean meat tomato sauce, add vegetables or serve with salad

COOL DOWN

Chicken and vegetable risotto

All training and games should finish with a proper cool

Grilled chicken with vegetables

down taking place over 10 — 20 minutes. Progressively

Home-made pizza (low-fat cheese and lean ham)

lower intensity to help speed the removal of lactic acid

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from the muscles and blood. Stretching exercises are an

temperature and may find the experience of going from a

important aspect of all cool downs.

warm environment in the training area or dressing room into a cold shower or ice bath painful, or may go into

REDUCING MUSCLE DAMAGE Muscle damage occurs naturally in each training session and game. Often the damage is microscopic, with the effects not being felt for up to 48 hours (often called Delayed Onset Muscle Soreness, or DOMS). Cooling the muscles after exercise is a good way to reduce muscular damage and soreness, with there being a number of different options for coaches to consider:

shock.

Always check how a player responds to cold

before use. Careful monitoring of players at this time is advised. It is always advisable to consult a doctor before introducing such regimes into the post training or game practice.

REDUCING PSYCHOLOGICAL SYMPTOMS OF FATIGUE Many players complain of being mentally fatigued after

CONTRAST RECOVERY (HOT/COLD) This involves submersion or covering the body in hot (must be bearable to the individual) water, followed by the same with cold water (with a temperature of approximately 15°C if possible). The guidelines for this are two minutes hot, followed by 30 seconds cold. This is repeated two-four times (as necessary).

training or games, or show symptoms of anxiety or irritability in the hours and days after a particularly tough training session or game. It should be noted that getting adequate sleep is a major part of ensuring recovery. Some players require more than others, but players should be encouraged to report if they have difficulty sleeping. Ensuring that players are properly recovered before undertaking the next training session or taking

COLD IMMERSION This is similar to above except it is just cold immersion. The guidelines for this form of training are 30 seconds – 1 minute immersion, followed by 1 minute out of water (towel dry). Repeat this three times.

part in the next game requires careful monitoring. Providing players with a training log and incorporating adequate hydration monitoring, will help to ensure that players are properly recovered. The training log will also help to identify early warning signs of under recovery.

ICE MASSAGE

TIP

This form involves ‘rubbing’ the muscle groups which have been trained, with ice. This can either be done with

Players should aim for at least 8 hours of quality

ice in a plastic bag, or a cooling bag. The guidelines for

sleep per night.

this are one minute on one minute off, for a total of four minutes on each area/limb. Make sure that you keep the

SCREENING

ice moving over your skin, do not keep the ice stationary

Functional Movement Screening (FMS) incorporates a

for any period of time as ice can burn! If you have any

series of movement tests to identify physical problems,

circulatory or sensory (e.g. paraesthesia) problems please

prevent sports injuries and predict potential for playing

check with your doctor.

success. The GAA and CPSEM FMS Protocol assess functional movement deficits through squat mechanics,

Extreme care must be taken when using these, as some

lower limb control, movement patterns and plyometrics,

players may be very sensitive to extreme changes in

dynamic stability and upper body control.

5

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mouthguard are chipped or broken teeth, fractured Where possible, screening should be carried out by a

crowns or bridgework, lip and cheek injuries, root

Chartered Physiotherapist with knowledge of Gaelic

damage to the teeth, fractured jaws. Mouthguards are

Games

mandatory for players in all age grades, in all Gaelic

and

experience

in

the

management

of

musculoskeletal problems. Screening should preferably

football practice sessions and games.

be carried out before a player’s season starts and also at the end of the year.

This will enable appropriate

For more information, visit:

measures to be agreed upon to prevent injury and

http://www.gaa.ie/medical-and-player-

enhance performance.

welfare/mouthguards/

FAIR PLAY

HELMETS

As Gaelic football and hurling are contact sports, play can

Research has shown that the wearing of helmets

become reckless and dangerous therefore the risk of

drastically reduce head injury rates. In all Hurling Games

injury is reduced. Players should:

and Hurling Practice Sessions it shall be mandatory for,

Understand the Rules of Play

and the responsibility of, each individual player to wear a

Play fair within the rules

helmet with a facial guard that meets the standard set out

Respect the decisions of referee’s by not

in IS:355 or other replacement standard as determined by

challenging them

the National Safety Authority of Ireland (NSAI). Such

Respect their team-mates and opponents

helmets shall not be modified from their original manufactured state in any circumstances. A Referee shall

To GAA’s Official Guide contain the Rules of the Association

and

can

be

access

by

not allow a helmet to be worn in a football game.

visiting

MANAGEMENT

http://www.gaa.ie/about-the-gaa/publications-andresources/

RICE PROTECTIVE EQUIPMENT Protective equipment is there to protect players from

The RICE principle can be helpful in treating many sportsrelated injuries:

injury and should be used as per the Rules of the Association whilst participating in Gaelic games.

R - REST You should rest the injured area for 24-48 hours.

MOUTHGUARDS The use of a properly fitted mouthguard is the best available protective device for reducing the incidence and severity of sports-related dental. Numerous studies have shown that the overall injury risk is close to twice as high when a mouthguard is not worn, relative to when mouthguards are used during athletic activity. The types of dental injuries that can occur without the use of a 6

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Crutches may be needed to take the weight off an injured knee or ankle. Make sure that you know how to use the crutches properly. Use them on the uninjured side to relieve pressure from the injured side. Support a strained elbow or shoulder with a sling. I - ICE Apply an ice pack (e.g. pack of frozen peas or a bag filled with crushed ice wrapped in a towel) as soon as the injury occurs. Repeat up to three times a day. To avoid

frostbite do not apply the ice pack for longer than 20

jumping, throwing or kicking.

Once you are able to

minutes.

perform these skills to the same level as before the

C - COMPRESSION

injury, you are ready to return to play. Don not return

Wrap the affected area in an elastic bandage tightly - but

to play until you are recovered from your injury as

not so tight as to cause compromise of the blood supply

retuning too soon can make your injury worse and delay

to the affected area.

recovery.

E - ELEVATION To reduce swelling, elevate the affected area above the level of the heart. It is important to SEEK HELP EARLY! If the pain or swelling has not gone down significantly within 48 hours, you should seek treatment. If you are worried about your injury you should consult with your local GP immediately.

THINGS TO AVOID Massage – this can increase bleeding and swelling and be avoided within 72 hours of an injury Running – do not resume exercise within 72 hours of your injury unless your medical professional says it’s ok to Heat – this increases bleeding at the injury site. Avoid hot baths, showers, saunas, heat packs etc… Alcohol - this can increase bleeding and swelling and delays healing. It can also mask pain.

RETURN TO PLAY If the RICE treatment is done correctly, the pain and swelling should decrease and pain free movements should return.

Some gentle movement at the right time is

important for healing and recovery.

When you start

exercising again, keep all movements within the limits of pain and never force any movement. If the pain or swelling returns, consult with your local GP. Before you return to play, you need to make sure you can do the specific tasks your sports require, such as 7

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